Naturalization Process for People with Dementia

Naturalization is the process by which foreign-born individuals become United States citizens. This process is under the direction of the United States Citizenship and Immigration Services (USCIS), formerly the Immigration and Naturalization Service (INS).

Elderly applicants have a unique set of needs in the naturalization process, especially those suffering from a disability such as dementia. Seniors have varied language and health needs that require special attention. The elderly do not fit neatly into the USCIS naturalization process; they face many issues given the barriers encountered due to agerelated problems.

The benefits of citizenship include the right to vote, to bring family members to the U.S., and to travel with a U.S. passport, to name a few. In order to apply for naturalization, the N-400 application form must be completed along with a filing fee of $595, and a subsequent interview is required.

An applicant must demonstrate the following in order to become naturalized:

• a period of continuous residence and physical presence in the United States;
• residence in a particular USCIS District prior to filing;
• an ability to read, write and speak English;
• a knowledge and understanding of U.S. history and government (also referred to as “civics”);
• good moral character; attachment to the principles of the U.S. Constitution;
• and favorable disposition toward the U.S.

This list of requirements oftentimes makes it difficult for certain seniors to become naturalized. An applicant suffering from an illness such as dementia will not be able to meet all of these requirements. Fortunately, certain exceptions are made in some circumstances. For example, individuals who are unable to demonstrate an understanding of the English language or knowledge of U.S. history and government due to a physical or developmental disability or mental impairment may be exempt from the English, history and government testing requirements. Applicants with disabilities, both physical and/or mental, may qualify for a disability waiver (Form N-648 -- Medical Certification for Disability Exceptions) exempting them from these two testing requirements. This includes individuals who are elderly and suffer from dementia, Alzheimer’s disease, severe depression, post traumatic stress disorder or any other related disease.

If the applicant’s mental impairment is so severe that he or she is unable to learn or demonstrate knowledge of English or civics, the applicant may be excused from these requirements through the disability waiver.

The disability waiver requires that the applicant have a physical or psychological examination performed by a licensed medical or osteopathic doctor or licensed clinical psychologist. The practitioner must complete the N-648 form in great detail, being careful to explain and certify the diagnosis; explain how he or she arrived at the diagnosis, including the use of any diagnostic tools such as lab tests; and explain how the impairment “affects the applicant’s ability to learn or demonstrate knowledge of English and/or U.S. history and government.” A causal relationship between the disability and the applicant’s inability to perform on the test, specifically his or her ability to learn or demonstrate knowledge of the English language and/or U.S. history and government, must exist. The USCIS may not question the medical determination made on the waiver; however, a disability waiver may be denied if the N-648 form is not filled out completely or properly. (Please note that the N-648 form must be filed along with the naturalization application.)

Being elderly in and of itself is not a medically determinable physical or developmental disability or mental impairment. However, an elderly applicant suffering from an age-related disease or disability which impairs learning (e.g.,Alzheimer’s disease, dementia, strokes, etc.) can qualify for a disability exception. In such cases, it is important to stress that the inability to learn is a result of the medically determinable disability or mental impairment, and not simply old age.

A disability waiver will not be granted if the physical or mental disability merely makes it difficult for the applicant to take the test. In such a case, the INS should make accommodations as necessary.

It should be noted that the disability waiver only applies to the English and U.S. history and government portions of the application. The rest of the application process must be completed without exception. Herein lies another major issue for those suffering from a disability. The USCIS requires that all applicants for naturalization have the ability to take a meaningful oath of allegiance to the U.S. As the law is currently written, the oath requirement cannot be waived for adult naturalization applicants. An applicant’s understanding of the oath is generally tested at the interview. There is much debate surrounding this issue given that those applicants requesting a disability waiver may not be able to understand or communicate the meaning of the oath. Therefore, an applicant may be able to obtain a disability waiver but still be ineligible to become naturalized because he or she is unable to understand and/or communicate the oath.

The waiver available to those applicants with disabilities has been in dispute since its inception; it still remains difficult to obtain the waivers. Applicants with disabilities should seek the help of an advocate to aid him or her through the naturalization process.

— Bernard A. Krooks,
Certified Elder Law Attorney

Bernard A. Krooks, a Certified Elder Law Attorney, is a founding partner of Littman Krooks LLP, an elder law firm based in Manhattan. Mr. Krooks is past President of the National Academy of Elder Law Attorneys (NAELA), past President of the NY Chapter of NAELA, and past Chair of the Elder Law Section of the New York State Bar Association. For more information about Mr. Krooks and Littman Krooks LLP, please visit www.littmankrooks.com.

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